How Much Does Infusion Therapy Cost?

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When you receive a chronic disease diagnosis, there is a whirlwind of thoughts and questions that come to mind. Though discussing treatment options is usually the top priority, the next question is often, “How much does infusion therapy cost?”

How infusion therapy works

Infusion therapy is an intravenous treatment for chronic diseases. Because it is administered directly into a vein, the medication travels straight to the affected area of the body, which delivers the medicine faster and in greater concentrations than oral medications.

Infusion therapy is also ideal when oral medication cannot be ingested or in emergencies when there is no other way to provide medication quickly to a patient in need.

Why infusion therapy is expensive

While infusion therapy can be an extremely effective way to treat chronic diseases, it often comes with a high price tag due to the extensive research behind development of these medications. Depending on the medication type and dosage, the cost of infusion therapy can range from $200 to $1,000 or more per treatment, with many patients needing multiple weekly treatments.

In addition to the manufacturer’s cost of the infusible drugs and biologics, there’s also a cost for the equipment and medical staff necessary for an infusion center to administer the medication.

At FlexCare, we make every effort to keep out-of-pocket costs low for patients. However, insurance companies may not always cover infusion therapy, which can be a financial burden for those living with chronic diseases.

Range of insurance coverage

There are two things for your insurance company to consider for coverage:

Infusion therapy, which is the process of administering the medication
Infusion, which is the prescribed medication

The first step to determine insurance coverage for your infusion therapy is to have a prescription from your physician. Your insurance company will typically not cover infusion therapies unless it is for a chronic illness, and they may require clinical notes from your physician to support the need for the medication. When your doctor first refers you to FlexCare for treatment, we’ll work with your insurance company to determine what documentation is needed and then request those files from you physician’s office and submit them for approval.

The majority of FlexCare’s patients receive some degree of insurance approval for infusion therapy because of the process our staff takes to provide documentation that supports the patient’s need for the medication. If your insurance company deems infusion therapy is not medically necessary for your treatment plan, you may be able to work with your physician to appeal their decision.

Assistance programs and support for applying to them

In the event your insurance company refuses to cover your infusion therapy or medication, there are some financial assistance programs available. Talk to us about your concerns so we can provide you with resources or discuss options for payment plans. Some manufacturers of these medications also have patient assistance programs that can help with the cost of medication.